Nancy Nickell

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%; and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications,” the authors wrote. Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%; and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications,” the authors wrote. Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%; and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications,” the authors wrote. Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%, and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University, Hanover, N.H., and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications.” Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%, and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University, Hanover, N.H., and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications.” Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

ACP, AMA Back 'Partnership' Bill

States would get federal support to experiment with covering the uninsured and pursuing disease management strategies under the bipartisan Health Partnership Act (S. 2772). The bill was introduced last month and has the support of the American College of Physicians, the American Medical Association, and the National Association of Counties, and would establish a Health Care Expansion and Improvement Commission at the Health and Human Services department. The commission could approve a variety of options that states could pursue to expand access to health care, including tax credit expansions, expansions of Medicaid or State Children's Health Insurance Programs (SCHIP), creation of pooling arrangements, single-payer systems, and health savings accounts. If the legislation were enacted, it would allow states to do an “end run” around Washington's gridlock on covering the uninsured, said Robert B. Doherty, senior vice president, government affairs and public policy, for ACP. Like the physician's code of “first, do no harm,” the experiments could not result in diminished coverage for anyone, Mr. Doherty said.

More Employees Decline Coverage

More Americans are declining their employers' offer of health insurance as premiums continue to rise, according to a study by the Robert Wood Johnson Foundation. Approximately 3 million fewer workers who were eligible for employer-sponsored health insurance enrolled in 2003, compared with 1998. The national increase in individual premiums from 1998 to 2003 was $1,027, a 42% increase after adjustments for inflation. In 1998 dollars the amount was $2,454; with the adjustment it stood at $3,481 in 2003, the foundation said in a statement. States with the biggest percentage drops include New Jersey, −12%; Nebraska, −11%; Wisconsin, −9%; Colorado, −9%, and Iowa, −9%. The survey used trend data from 1998 to 2003 from the federal Medical Expenditure Panel Survey-Insurance Component, collected and distributed by the Agency for Healthcare Research and Quality (AHRQ).

Off-Label Scrips Common

More than one in five prescriptions (21%) for commonly used medications were written for off-label indications, according to a nationally representative study. Further, 15% of those off-label prescriptions lacked any scientific evidence of efficacy, David D. Radley of Dartmouth University, Hanover, N.H., and his colleagues wrote in the Archives of Internal Medicine. Off-label prescription was rare among medications for glycemic control in diabetes (less than 1%), infrequent among analgesics (6%), and in drugs to lower lipid levels (7%). Off-label prescription was most common among cardiac drugs (antianginals, 46%; antiarrhythmics, 39%; and anticoagulants, 46%) as well as anticonvulsants, 46%; and asthma drugs, 42%. “Off-label prescription with limited or no scientific support was more common than supported off-label use in all therapeutic classes except diabetes therapies,” the authors wrote. However, many of the off-label prescriptions “represent a logical extension of the FDA-approved indications.” Off-label prescribing can lead to innovative treatments, but “policy makers must begin to consider strategies for mandatory postapproval surveillance” to curtail dangerous or wasteful practices, the authors concluded. The study was supported by AHRQ.

Medicare Formulary Guidance

If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed onto a plan at the beginning of the plan year. In addition, Part D plans can only change therapeutic categories and classes in a formulary at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand name drugs with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo. “Prescription drug therapies are constantly evolving, and new drug availability, new medical knowledge, and new opportunities for improving safety and quality in prescription drug use at a low cost will inevitably occur over the course of the year,” Ms. Block said in the memo to Part D sponsors.

Rare Disease Studies

Officials at the National Institutes of Health have launched the first clinical studies that are part of its Rare Diseases Clinical Research Network. The network has received a total of $71 million in 5-year funding awards to study rare diseases. In the next few months, more than 20 studies are expected to open in sites around the world. In one example, an investigator at the Johns Hopkins Vasculitis Center in Baltimore will conduct a study of giant cell arteritis. “By studying the genetic component of these rare diseases, we hope to be able to better predict the course of the illnesses and provide more effective, personalized treatments for those afflicted,” Dr. Elias A. Zerhouni, NIH director, said in a statement.

SCHIP Funds Reallocated

Pediatricians in 12 states and five territories who feared that State Children's Health Insurance Program (SCHIP) money would run out can breathe a little easier; federal checks to their programs are in the mail. The Centers for Medicare and Medicaid Services announced that unspent funds would be reallocated to states in greatest need, an established process. This year, the surplus totaled $173 million, falling “far short of the $456 million that was needed to keep every SCHIP program running,” CMS said in a statement; therefore, the remaining funds were appropriated via the Deficit Reduction Act. States such as Illinois needed the extra funds because they are “doing a great job” of enrolling children and adolescents in SCHIP, said Dr. Mark Rosenberg, a Chicago pediatrician who serves on a governmental affairs committee for the American Academy of Pediatrics. Of the funds redistributed, Illinois received $117.5 million; Iowa, $6 million; Maryland, $13.7 million; Massachusetts, $21.9 million; Minnesota, $20 million; Mississippi, $73.6 million; Missouri, $8 million; Nebraska, $15.7 million; New Jersey, $105.6 million; North Carolina, $2.8 million; Rhode Island, $66 million; and South Dakota, $0.5 million. The SCHIP program differs from Medicaid, an open-ended program under which states can ask for matching funds, according to CMS. Under SCHIP, allocations of federal money are made based on a 3-year budget estimate.

Boost Active Living in 2006–2007

Sustainable active-living policies have the best chance of reversing current trends in pediatric obesity, and the 2006–2007 school year brings a new opportunity for pediatricians to advocate such policies. Writing in the journal Pediatrics, the Council on Sports Medicine and Fitness and Council on School Health said that federal legislation reauthorizing the Supplemental Nutrition Program for Women, Infants, and Children program has created that window. That law requires every school getting funding through the National School Lunch and/or Breakfast Program to develop a local wellness policy with a particular focus on obesity. “[Physical education] curricula and instruction should emphasize the knowledge, attitudes, and motor and behavioral skills required to adopt and maintain lifelong habits of physical activity,” the authors recommended, citing a study of 9,751 kindergarten students in which overweight girls significantly reduced their body mass index when physical education instruction time expanded. “Despite a significant increase in PE class time, there was no interference with academic attainment, and some achievement test results improved,” the authors said. But PE is not enough, and neither are organized sports, they noted. Children and adolescents should be encouraged to accumulate at least 60 minutes of physical activity a day, they said.

Bullying May Discourage Exercise

Bullying may deter overweight youth from physical activity, a preliminary study found. Eric A. Storch, Ph.D, and his colleagues at the University of Florida surveyed 92 at-risk-for-overweight and overweight children and adolescents who attended a scheduled appointment at the University of Florida Pediatric Lipid Clinic and asked them about peer victimization, psychosocial adjustment, and physical activity. “Overall, peer victimization was negatively associated with physical activity and positively associated with self-reports of depressive symptoms, anxiety, loneliness, and social physique anxiety, and parent reports of internalizing and externalizing behavior problems,” the authors wrote. The Social Skills Group Intervention can help in the school environment, they continued in the April edition of the Journal of Pediatric Psychology. Clinicians might “discuss the methods of countering bullying and help the youngster problem-solve ways to exercise without risking being bullied,” they added. However, the bullying may not always result from “being different” by virtue of greater body mass. Social skills deficits and disruptive behavior might also be factors, Dr. Storch and colleagues noted.

Underage Drinking Up—and Down

Underage alcohol use was up in California and Wisconsin in 2003–2004, compared with a year earlier, but down in Michigan and South Carolina, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey found that the percentage of 12- to 20-year-olds using alcohol within the past month rose from 24.7% to 26.3% in California and from 34.7% to 38.3% in Wisconsin. The percentage fell in Michigan, from 31.8% to 30.2%, and in South Carolina, from 27.3% to 24.1%. “While we are making progress on drug and tobacco use among youth, underage drinking continues as a stubbornly persistent problem,” said SAMHSA Administrator Charles Curie. “It's time to change attitudes toward teen drinking from acceptance to abstinence.”

SCHIP Funds Reallocated

Pediatricians in 12 states and five territories who feared that State Children's Health Insurance Program (SCHIP) money would run out can breathe a little easier; federal checks to their programs are in the mail. The Centers for Medicare and Medicaid Services announced that unspent funds would be reallocated to states in greatest need, an established process. This year, the surplus totaled $173 million, falling “far short of the $456 million that was needed to keep every SCHIP program running,” CMS said in a statement; therefore, the remaining funds were appropriated via the Deficit Reduction Act. States such as Illinois needed the extra funds because they are “doing a great job” of enrolling children and adolescents in SCHIP, said Dr. Mark Rosenberg, a Chicago pediatrician who serves on a governmental affairs committee for the American Academy of Pediatrics. Of the funds redistributed, Illinois received $117.5 million; Iowa, $6 million; Maryland, $13.7 million; Massachusetts, $21.9 million; Minnesota, $20 million; Mississippi, $73.6 million; Missouri, $8 million; Nebraska, $15.7 million; New Jersey, $105.6 million; North Carolina, $2.8 million; Rhode Island, $66 million; and South Dakota, $0.5 million. The SCHIP program differs from Medicaid, an open-ended program under which states can ask for matching funds, according to CMS. Under SCHIP, allocations of federal money are made based on a 3-year budget estimate.

Boost Active Living in 2006–2007

Sustainable active-living policies have the best chance of reversing current trends in pediatric obesity, and the 2006–2007 school year brings a new opportunity for pediatricians to advocate such policies. Writing in the journal Pediatrics, the Council on Sports Medicine and Fitness and Council on School Health said that federal legislation reauthorizing the Supplemental Nutrition Program for Women, Infants, and Children program has created that window. That law requires every school getting funding through the National School Lunch and/or Breakfast Program to develop a local wellness policy with a particular focus on obesity. “[Physical education] curricula and instruction should emphasize the knowledge, attitudes, and motor and behavioral skills required to adopt and maintain lifelong habits of physical activity,” the authors recommended, citing a study of 9,751 kindergarten students in which overweight girls significantly reduced their body mass index when physical education instruction time expanded. “Despite a significant increase in PE class time, there was no interference with academic attainment, and some achievement test results improved,” the authors said. But PE is not enough, and neither are organized sports, they noted. Children and adolescents should be encouraged to accumulate at least 60 minutes of physical activity a day, they said.

Bullying May Discourage Exercise

Bullying may deter overweight youth from physical activity, a preliminary study found. Eric A. Storch, Ph.D, and his colleagues at the University of Florida surveyed 92 at-risk-for-overweight and overweight children and adolescents who attended a scheduled appointment at the University of Florida Pediatric Lipid Clinic and asked them about peer victimization, psychosocial adjustment, and physical activity. “Overall, peer victimization was negatively associated with physical activity and positively associated with self-reports of depressive symptoms, anxiety, loneliness, and social physique anxiety, and parent reports of internalizing and externalizing behavior problems,” the authors wrote. The Social Skills Group Intervention can help in the school environment, they continued in the April edition of the Journal of Pediatric Psychology. Clinicians might “discuss the methods of countering bullying and help the youngster problem-solve ways to exercise without risking being bullied,” they added. However, the bullying may not always result from “being different” by virtue of greater body mass. Social skills deficits and disruptive behavior might also be factors, Dr. Storch and colleagues noted.

Underage Drinking Up—and Down

Underage alcohol use was up in California and Wisconsin in 2003–2004, compared with a year earlier, but down in Michigan and South Carolina, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey found that the percentage of 12- to 20-year-olds using alcohol within the past month rose from 24.7% to 26.3% in California and from 34.7% to 38.3% in Wisconsin. The percentage fell in Michigan, from 31.8% to 30.2%, and in South Carolina, from 27.3% to 24.1%. “While we are making progress on drug and tobacco use among youth, underage drinking continues as a stubbornly persistent problem,” said SAMHSA Administrator Charles Curie. “It's time to change attitudes toward teen drinking from acceptance to abstinence.”

SCHIP Funds Reallocated

Pediatricians in 12 states and five territories who feared that State Children's Health Insurance Program (SCHIP) money would run out can breathe a little easier; federal checks to their programs are in the mail. The Centers for Medicare and Medicaid Services announced that unspent funds would be reallocated to states in greatest need, an established process. This year, the surplus totaled $173 million, falling “far short of the $456 million that was needed to keep every SCHIP program running,” CMS said in a statement; therefore, the remaining funds were appropriated via the Deficit Reduction Act. States such as Illinois needed the extra funds because they are “doing a great job” of enrolling children and adolescents in SCHIP, said Dr. Mark Rosenberg, a Chicago pediatrician who serves on a governmental affairs committee for the American Academy of Pediatrics. Of the funds redistributed, Illinois received $117.5 million; Iowa, $6 million; Maryland, $13.7 million; Massachusetts, $21.9 million; Minnesota, $20 million; Mississippi, $73.6 million; Missouri, $8 million; Nebraska, $15.7 million; New Jersey, $105.6 million; North Carolina, $2.8 million; Rhode Island, $66 million; and South Dakota, $0.5 million. The SCHIP program differs from Medicaid, an open-ended program under which states can ask for matching funds, according to CMS. Under SCHIP, allocations of federal money are made based on a 3-year budget estimate.

Boost Active Living in 2006–2007

Sustainable active-living policies have the best chance of reversing current trends in pediatric obesity, and the 2006–2007 school year brings a new opportunity for pediatricians to advocate such policies. Writing in the journal Pediatrics, the Council on Sports Medicine and Fitness and Council on School Health said that federal legislation reauthorizing the Supplemental Nutrition Program for Women, Infants, and Children program has created that window. That law requires every school getting funding through the National School Lunch and/or Breakfast Program to develop a local wellness policy with a particular focus on obesity. “[Physical education] curricula and instruction should emphasize the knowledge, attitudes, and motor and behavioral skills required to adopt and maintain lifelong habits of physical activity,” the authors recommended, citing a study of 9,751 kindergarten students in which overweight girls significantly reduced their body mass index when physical education instruction time expanded. “Despite a significant increase in PE class time, there was no interference with academic attainment, and some achievement test results improved,” the authors said. But PE is not enough, and neither are organized sports, they noted. Children and adolescents should be encouraged to accumulate at least 60 minutes of physical activity a day, they said.

Bullying May Discourage Exercise

Bullying may deter overweight youth from physical activity, a preliminary study found. Eric A. Storch, Ph.D, and his colleagues at the University of Florida surveyed 92 at-risk-for-overweight and overweight children and adolescents who attended a scheduled appointment at the University of Florida Pediatric Lipid Clinic and asked them about peer victimization, psychosocial adjustment, and physical activity. “Overall, peer victimization was negatively associated with physical activity and positively associated with self-reports of depressive symptoms, anxiety, loneliness, and social physique anxiety, and parent reports of internalizing and externalizing behavior problems,” the authors wrote. The Social Skills Group Intervention can help in the school environment, they continued in the April edition of the Journal of Pediatric Psychology. Clinicians might “discuss the methods of countering bullying and help the youngster problem-solve ways to exercise without risking being bullied,” they added. However, the bullying may not always result from “being different” by virtue of greater body mass. Social skills deficits and disruptive behavior might also be factors, Dr. Storch and colleagues noted.

Underage Drinking Up—and Down

Underage alcohol use was up in California and Wisconsin in 2003–2004, compared with a year earlier, but down in Michigan and South Carolina, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey found that the percentage of 12- to 20-year-olds using alcohol within the past month rose from 24.7% to 26.3% in California and from 34.7% to 38.3% in Wisconsin. The percentage fell in Michigan, from 31.8% to 30.2%, and in South Carolina, from 27.3% to 24.1%. “While we are making progress on drug and tobacco use among youth, underage drinking continues as a stubbornly persistent problem,” said SAMHSA Administrator Charles Curie. “It's time to change attitudes toward teen drinking from acceptance to abstinence.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” said AMA Board Member Dr. Edward Langston in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP, and AAFP Web sites.

PBMs Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” said AMA Board Member Dr. Edward Langston in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP, and AAFP Web sites.

PBMs Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” said AMA Board Member Dr. Edward Langston in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP, and AAFP Web sites.

PBMs Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” AMA board member Dr. Edward Langston said in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP and AAFP Web sites.

Critics Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all that they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs that are due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” AMA board member Dr. Edward Langston said in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP and AAFP Web sites.

Critics Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all that they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs that are due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Boomers: Speed Alzheimer's Drugs

Current treatments and policies fail to “adequately address [the] looming public health crisis” of Alzheimer's disease, a survey of U.S. baby boomers has found. Most respondents (80%) said that they are willing to take experimental treatments that have the potential for stopping the disease and preserving their quality of life, “even if significant health risk was involved,” the study found. The Web-based survey was commissioned by Accelerate Cure/Treatments for Alzheimer's Disease (ACT-AD), a coalition representing patients, caregivers, consumers, older Americans, researchers, and women's health advocates. The survey was conducted by Opinion Research Corp., which sampled 1,009 Americans born between 1946 and 1964. When provided with basic information on Alzheimer's disease, most respondents were extremely concerned about the potential impact on their health, quality of life, and finances as well as on the health care system, ACT-AD said in a statement. Boomers “place top priority on new drugs that could change the course of the disease, feel that FDA should give priority review to those drugs, expect the right to decide whether to use them, and are willing to accept a degree of risk with promising drugs,” according to the group. ACT-AD receives support from Elan Corp. and Wyeth Pharmaceuticals, which are developing treatments for Alzheimer's.

Part D Formulary Override Form

A coalition of physician and pharmacist organizations and insurers, led by the American Medical Association, has developed a form that all physicians can use to request a prior authorizations or coverage of a nonformulary drug under Medicare's Part D benefit. Partners include the American Psychiatric Association, the American Academy of Family Physicians, the American College of Physicians, the National Council on the Aging, the American Pharmacists Association, and America's Health Insurance Plans. “Physicians will now have a simple one-page form to easily communicate to drug plans why a patient needs a specific drug when other similar drugs are also covered by the plan,” AMA board member Dr. Edward Langston said in a statement. With the form, physicians can explain why an alternate drug is needed, why a different dose is required, or why the formulary drug is not acceptable. It is available on the Centers for Medicare and Medicaid Services Web site and also at the AMA, AHIP and AAFP Web sites.

Critics Say Generics Thwarted

At least 14 brand name drugs are due to go off-patent in the next 5 years, representing $23 billion in potential savings to Medicare Part D, but pharmaceutical manufacturers are doing all that they can to block generic competition, claims the Pharmaceutical Care Management Association in a new report. PCMA's members—managed drug benefit plans—negotiate discounts with drug makers on behalf of employers and insurers and are under pressure to keep pharmaceutical prices down so they can offer competitively priced plans to Medicare beneficiaries. The organization says that this year alone, $1.5 billion could be saved on four drugs that are due to lose exclusivity: Zoloft (sertraline), Zocor (simvastatin), Proscar (finasteride), and Pravachol (pravastatin). The Food and Drug Administration just approved a generic pravastatin. The savings assume that 90% of Medicare prescriptions would be switched to generics, and that the generic would cost 60% less than the brand. In 2007, seven popular products—Norvasc (amlodipine besylate), Ambien (zoldipem tartrate), Zyrtec (cetirizine), Lotrel (amlodipine/benazepril), Coreg (carvedilol), Lamisil (terbinafine), and Tequin (gatifloxicin), are due to lose patent protection, noted PCMA, which could lead to $700 million in savings that year. But the group said that drug companies have opposed legislation that would speed generics to market or that would mandate generic substitution.

Medicare Trustees Report

The federal Hospital Insurance Trust Fund—better known as Medicare Part A—is not adequately funded to meet the needs of future beneficiaries, according to the annual report of the Social Security and Medicare Trustees. “The Hospital Insurance Trust Fund is not adequately financed over the next 10 years,” the report said. “From the beginning of 2006 to the end of 2015, the assets of the Hospital Insurance Trust Fund are projected to decrease from $286 billion to $197 billion, which would be less than the recommended minimum level of 1 year's expenditures.” The trustees added that “the financial outlook for the Medicare program continues to raise serious concerns.” Senate Majority Leader Dr. Bill Frist (R-Tenn.) took an upbeat approach to the report, pointing out that it showed the costs of the new Medicare prescription drug benefit are significantly lower than in previous reports. “However, the trustees also make it clear that much work remains to be done to address the growth of Medicare spending,” he said in a statement. The American Medical Association focused on the report's projected “steep long-term cuts” in Medicare payments to physicians. “[This] report on the dire future of Medicare cries out for reforms to ensure that Medicare will be there for future generations,” Dr. Duane Cady, chair of the AMA board of trustees, said in a statement. “Congress must take an immediate step to preserve seniors' access to physicians by tying Medicare physician payments to the cost of caring for seniors.”

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Uninsured Get Inefficient Care

The uninsured not only face a “downward spiral” in health, they also experience inefficiencies in care, a report from the Commonwealth Fund found. Uninsured persons are more likely to go without the care or screening tests that could prevent serious health problems, are less likely to have a regular doctor (41% vs. 86% of insured adults), and are more likely to face fragmented care. “Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results of records were not available at the time of a doctor's appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10% of insured adults,” the study said. Researchers found that an “alarmingly high proportion (59%) of adults” with chronic illnesses such as diabetes and asthma who were uninsured for a time in the past year went without their medications because they couldn't afford them. The findings are from the Commonwealth Fund Biennial Health Insurance Survey, a nationally representative sample of 4,350 U.S. adults aged 19 years and older, conducted via phone August 2005-January 2006. This analysis focuses on the population aged 19–64.

Glaucoma Screening

Hispanic Americans aged 65 years and older are now eligible for glaucoma screening under Medicare. Medicare will pay for glaucoma screening exams provided by (or under the direct supervision of) an ophthalmologist or optometrist who is legally authorized to perform the services under state law. At least 11 months must have passed since the last covered screening. In 2002, Medicare began covering glaucoma screening for patients with diabetes, those with family history of glaucoma, and for African American beneficiaries aged 50 years and older—all of whom are considered to be at high risk for the disease.

FDA Eyes Phase IV

The Food and Drug Administration has hired a contractor to conduct a thorough evaluation of the postmarketing study process for collecting information about drugs, devices, and biologics, the agency said in a statement. Such phase IV studies help to further define a product's safety, efficiency, or optimal use, the agency said. “Greater internal consistency across the medical centers at FDA for requiring, requesting, facilitating, and reviewing postmarketing study commitments” is the goal. Booz Allen Hamilton was awarded the contract last month, and is expected to take about a year to finish, according to the FDA.

Part D Cash Flow Woes

Administrative improvements in Medicare Part D have not eased cash flow pains for independent pharmacists, a survey found. The National Community Pharmacists Association surveyed 5,000 of its members; one-third said the Part D cash flow crisis may threaten the viability of their businesses. During the program's initial days, pharmacists nationwide dispensed millions of dollars in emergency prescriptions when eligibility could not be verified, and claims could not be processed due to problems with plan databases. Even now, payment procedures for low-income seniors eligible for both Medicare and Medicaid have “drastically slowed payment schedules,” the NCPA said. Under Medicaid, pharmacists were reimbursed weekly; under Medicare Part D, prescription drug plans issue reimbursement checks generally only once every 4 weeks and prescription claims filing may delay payment by additional weeks. Some 525 independent pharmacies (10.5%) responded to the faxed survey.

Prescribing Scooters, Wheelchairs

Prescribing power wheelchairs and scooters for patients should be easier under a new Medicare rule. The final rule, published in the Federal Register, requires a face-to-face evaluation, but also extends the time allowed to submit the prescription and other paperwork to the supplier from 30 days to 45. Also, a requirement that a specialist physician such as an orthopedic surgeon or rheumatologist assess the patient's ability to operate the equipment has been removed. An additional payment has been provided via an add-on CPT code to recognize the additional work and resources required to document the patient's need for a power device. A beneficiary being discharged from the hospital does not need to have a separate face-to-face exam. If a physician has an established treatment relationship with a patient, a face-to-face exam is not required, but documentation of need based on previous visits must be provided, according to the rule.

Tobacco Settlement Funds Waning

States will likely receive $400 million less tobacco settlement funds in fiscal year 2006 than in 2005, a Governmental Accountability Office study has found. GAO said the decline occurred because states have been selling bonds based on expected revenue from tobacco companies. States are “selling proceeds for pennies on the dollar,” and will have less to spend on health care, said Eric Lindblom, director for policy research at the Campaign for Tobacco-Free Kids. Tobacco settlement money was supposed to be spent on public health, especially to prevent smoking and treat its effects, he said, adding that when states have million of dollars coming in from tobacco companies, it is easier for health advocates to push for spending on smoking-related health matters. A recent paper from the campaign said that California and Massachusetts were saving as much as $3 in smoking-related health-care costs for every dollar spent on tobacco prevention when their programs were adequately funded. This is the last such report the GAO is set to perform under current federal law.

Mass. to Add a Recovery High School

This fall, the first high school designed to meet the needs of Massachusetts students recovering from addiction will open its doors in Beverly, said Lt. Gov. Kerry Healy. Such schools provide “an opportunity for kids to continue their education in a place that is free from the social pressures that often lead to relapse” of addiction, she said in a statement. To avoid the pressure, students often drop out of school entirely, she added. The Beverly recovery high school will be administered by the Northshore Education Consortium, an organization of 17 school districts. The consortium was awarded $1.5 million from the state over the next 5 years, including $500,000 for start-up costs in the first year and $250,000 in subsequent years. The school will be set up similarly to a charter school, with participating cities responsible for the per-pupil costs. The recovery school movement began in Minnesota in 1989, and about 22 such high schools exist nationwide, according to Laura Nicoll, a spokeswoman for Lt. Gov. Healy. School officials will reach out to residential and outpatient adolescent treatment providers, public schools, and juvenile courts as well as the Department of Youth Services and the Department of Social Services. Plans are underway for additional schools in western Massachusetts and Boston.

Bill Junks Junk Food in Schools

Legislation wending its way through Congress aims to keep junk foods out of U.S. schools. “The bipartisan Child Nutrition Promotion and School Lunch Protection Act would update decades-old federal nutrition standards for snack foods sold in school cafeterias alongside the regular school meals, and would apply those standards everywhere on school grounds, including in vending machines and school stores,” according to a statement from Sen. Tom Harkin's (D-Iowa) office. His bill (S. 2592) had six cosponsors; its House of Representatives counterpart (H.R. 5167) was introduced by Rep. Lynn C. Woolsey (D-Calif.). The bill would require the U.S. Department of Agriculture to revise its definition of “food of minimal nutritional value.” The bill is supported by the American College of Preventive Medicine, the American Public Health Association, the American Cancer Society, and the American Diabetes Association, among other organizations.

Teen Lawn Mower Injuries Rev Up

Youth aged 15–19 years had the highest rate of hospitalizations from lawn mower injuries, and injuries to those under age 15 years increased substantially from 1996 through 2003, according to a study published in the Annals of Emergency Medicine (2006;[doi:10.1016/j.annemergmed. 2006.02.020]). Vanessa Costilla of Rice University, Houston, and Dr. David M. Bishai of Johns Hopkins University, Baltimore, looked at data from the National Electronic Injury Surveillance System and found 663,393 lawn mower injuries treated in U.S. emergency departments—an average of 74,000 visits per year. Debris from under the mower hitting a bystander was the most common mechanism for lawn mower injury; in children aged 15 years and younger, burns from hot surfaces and running over an extremity were also frequent mechanisms for injury. Such injuries would be “completely preventable if children could be kept away from lawn mowers” and out of yards when mowers are being used, the authors wrote. “Health professionals and community educators can take an active role in warning parents about the dangers of lawn mowers.”

Children's Health Study Funding Cut

A national study on children's health that would return “significant value to the taxpayers” has been slashed from the Bush administration's budget proposal for the National Institutes of Health, according to Rep. Doris O. Matsui (D-Calif.). The National Children's Study, the largest long-term study of human health and development ever conducted in the United States, aims to examine many aspects of children's lives, from family genetics to the social and behavioral environment in which children develop. The study is designed to observe 100,000 children from birth to their 21st birthdays. Pregnant women, couples planning pregnancy, and women of childbearing age not planning pregnancy also are among the subjects. Enrollment of 250 newborns each year for 5 years was set to start in 2007. Some families are already on waiting lists, according to a spokeswoman for Rep. Matsui. “Should the study's research reduce the incidence of childhood injuries, autism, asthma, schizophrenia, and obesity by just 1%—an extremely conservative estimate—the study would pay for itself twofold within 1 year,” said the spokeswoman. The Children's Health Act of 2000 authorized the National Institute of Child Health and Human Development and a consortium of federal agencies to conduct the study.

Mass. to Add a Recovery High School

This fall, the first high school designed to meet the needs of Massachusetts students recovering from addiction will open its doors in Beverly, said Lt. Gov. Kerry Healy. Such schools provide “an opportunity for kids to continue their education in a place that is free from the social pressures that often lead to relapse” of addiction, she said in a statement. To avoid the pressure, students often drop out of school entirely, she added. The Beverly recovery high school will be administered by the Northshore Education Consortium, an organization of 17 school districts. The consortium was awarded $1.5 million from the state over the next 5 years, including $500,000 for start-up costs in the first year and $250,000 in subsequent years. The school will be set up similarly to a charter school, with participating cities responsible for the per-pupil costs. The recovery school movement began in Minnesota in 1989, and about 22 such high schools exist nationwide, according to Laura Nicoll, a spokeswoman for Lt. Gov. Healy. School officials will reach out to residential and outpatient adolescent treatment providers, public schools, and juvenile courts as well as the Department of Youth Services and the Department of Social Services. Plans are underway for additional schools in western Massachusetts and Boston.

Bill Junks Junk Food in Schools

Legislation wending its way through Congress aims to keep junk foods out of U.S. schools. “The bipartisan Child Nutrition Promotion and School Lunch Protection Act would update decades-old federal nutrition standards for snack foods sold in school cafeterias alongside the regular school meals, and would apply those standards everywhere on school grounds, including in vending machines and school stores,” according to a statement from Sen. Tom Harkin's (D-Iowa) office. His bill (S. 2592) had six cosponsors; its House of Representatives counterpart (H.R. 5167) was introduced by Rep. Lynn C. Woolsey (D-Calif.). The bill would require the U.S. Department of Agriculture to revise its definition of “food of minimal nutritional value.” The bill is supported by the American College of Preventive Medicine, the American Public Health Association, the American Cancer Society, and the American Diabetes Association, among other organizations.

Teen Lawn Mower Injuries Rev Up

Youth aged 15–19 years had the highest rate of hospitalizations from lawn mower injuries, and injuries to those under age 15 years increased substantially from 1996 through 2003, according to a study published in the Annals of Emergency Medicine (2006;[doi:10.1016/j.annemergmed. 2006.02.020]). Vanessa Costilla of Rice University, Houston, and Dr. David M. Bishai of Johns Hopkins University, Baltimore, looked at data from the National Electronic Injury Surveillance System and found 663,393 lawn mower injuries treated in U.S. emergency departments—an average of 74,000 visits per year. Debris from under the mower hitting a bystander was the most common mechanism for lawn mower injury; in children aged 15 years and younger, burns from hot surfaces and running over an extremity were also frequent mechanisms for injury. Such injuries would be “completely preventable if children could be kept away from lawn mowers” and out of yards when mowers are being used, the authors wrote. “Health professionals and community educators can take an active role in warning parents about the dangers of lawn mowers.”

Children's Health Study Funding Cut

A national study on children's health that would return “significant value to the taxpayers” has been slashed from the Bush administration's budget proposal for the National Institutes of Health, according to Rep. Doris O. Matsui (D-Calif.). The National Children's Study, the largest long-term study of human health and development ever conducted in the United States, aims to examine many aspects of children's lives, from family genetics to the social and behavioral environment in which children develop. The study is designed to observe 100,000 children from birth to their 21st birthdays. Pregnant women, couples planning pregnancy, and women of childbearing age not planning pregnancy also are among the subjects. Enrollment of 250 newborns each year for 5 years was set to start in 2007. Some families are already on waiting lists, according to a spokeswoman for Rep. Matsui. “Should the study's research reduce the incidence of childhood injuries, autism, asthma, schizophrenia, and obesity by just 1%—an extremely conservative estimate—the study would pay for itself twofold within 1 year,” said the spokeswoman. The Children's Health Act of 2000 authorized the National Institute of Child Health and Human Development and a consortium of federal agencies to conduct the study.

Mass. to Add a Recovery High School

This fall, the first high school designed to meet the needs of Massachusetts students recovering from addiction will open its doors in Beverly, said Lt. Gov. Kerry Healy. Such schools provide “an opportunity for kids to continue their education in a place that is free from the social pressures that often lead to relapse” of addiction, she said in a statement. To avoid the pressure, students often drop out of school entirely, she added. The Beverly recovery high school will be administered by the Northshore Education Consortium, an organization of 17 school districts. The consortium was awarded $1.5 million from the state over the next 5 years, including $500,000 for start-up costs in the first year and $250,000 in subsequent years. The school will be set up similarly to a charter school, with participating cities responsible for the per-pupil costs. The recovery school movement began in Minnesota in 1989, and about 22 such high schools exist nationwide, according to Laura Nicoll, a spokeswoman for Lt. Gov. Healy. School officials will reach out to residential and outpatient adolescent treatment providers, public schools, and juvenile courts as well as the Department of Youth Services and the Department of Social Services. Plans are underway for additional schools in western Massachusetts and Boston.

Bill Junks Junk Food in Schools

Legislation wending its way through Congress aims to keep junk foods out of U.S. schools. “The bipartisan Child Nutrition Promotion and School Lunch Protection Act would update decades-old federal nutrition standards for snack foods sold in school cafeterias alongside the regular school meals, and would apply those standards everywhere on school grounds, including in vending machines and school stores,” according to a statement from Sen. Tom Harkin's (D-Iowa) office. His bill (S. 2592) had six cosponsors; its House of Representatives counterpart (H.R. 5167) was introduced by Rep. Lynn C. Woolsey (D-Calif.). The bill would require the U.S. Department of Agriculture to revise its definition of “food of minimal nutritional value.” The bill is supported by the American College of Preventive Medicine, the American Public Health Association, the American Cancer Society, and the American Diabetes Association, among other organizations.

Teen Lawn Mower Injuries Rev Up

Youth aged 15–19 years had the highest rate of hospitalizations from lawn mower injuries, and injuries to those under age 15 years increased substantially from 1996 through 2003, according to a study published in the Annals of Emergency Medicine (2006;[doi:10.1016/j.annemergmed. 2006.02.020]). Vanessa Costilla of Rice University, Houston, and Dr. David M. Bishai of Johns Hopkins University, Baltimore, looked at data from the National Electronic Injury Surveillance System and found 663,393 lawn mower injuries treated in U.S. emergency departments—an average of 74,000 visits per year. Debris from under the mower hitting a bystander was the most common mechanism for lawn mower injury; in children aged 15 years and younger, burns from hot surfaces and running over an extremity were also frequent mechanisms for injury. Such injuries would be “completely preventable if children could be kept away from lawn mowers” and out of yards when mowers are being used, the authors wrote. “Health professionals and community educators can take an active role in warning parents about the dangers of lawn mowers.”

Children's Health Study Funding Cut

A national study on children's health that would return “significant value to the taxpayers” has been slashed from the Bush administration's budget proposal for the National Institutes of Health, according to Rep. Doris O. Matsui (D-Calif.). The National Children's Study, the largest long-term study of human health and development ever conducted in the United States, aims to examine many aspects of children's lives, from family genetics to the social and behavioral environment in which children develop. The study is designed to observe 100,000 children from birth to their 21st birthdays. Pregnant women, couples planning pregnancy, and women of childbearing age not planning pregnancy also are among the subjects. Enrollment of 250 newborns each year for 5 years was set to start in 2007. Some families are already on waiting lists, according to a spokeswoman for Rep. Matsui. “Should the study's research reduce the incidence of childhood injuries, autism, asthma, schizophrenia, and obesity by just 1%—an extremely conservative estimate—the study would pay for itself twofold within 1 year,” said the spokeswoman. The Children's Health Act of 2000 authorized the National Institute of Child Health and Human Development and a consortium of federal agencies to conduct the study.

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr.P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiff's attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients … GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr.P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiff's attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients … GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr.P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiff's attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients … GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr. P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiffs' attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients… GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr. P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiffs' attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients… GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem

Charity Health Care Declines

The decade-long decline in the proportion of physicians providing charity care continued in 2004–2005, according to a study by the Center for Studying Health System Change. The percentage of physicians providing any free or reduced-fee care decreased to 68% in 2004–2005, down from 72% in 2000–2001. “Declines in charity care were observed across most major specialties, practice types, practice income levels, and geographic regions,” study authors Peter J. Cunningham, Ph.D., and Jessica H. May wrote. “Increasing financial pressures and changes in practice arrangements may account in part for the continuing decrease in physician charity care.” More than 70% of physicians providing charity care reported that they typically did so in their own practice, while 14% provided it while on call in a hospital emergency department and 6% in another practice or clinic. The researchers noted that surgical specialists were the most likely among specialty physicians to provide charity care, probably because many are required to be on call at hospitals and therefore have less choice about whether to treat uninsured patients. Pediatricians were the least likely to provide charity care, which perhaps reflects the fact that more children than adults have public health coverage, they said.

Cigarette Smoking Rate Stubbed

The number of cigarettes sold in the United States in 2005 dropped just over 4% from 2004, the largest 1-year percentage decrease in sales since 1999, according to figures compiled by the Treasury Department. “We are pleased to see that the long decline of cigarette consumption is continuing,” Cheryl Healton, Dr. P.H., president of the American Legacy Foundation, said in statement. “We also know that for the first time in the United States, there are more former smokers than current smokers.” The National Association of Attorneys General also applauded the numbers, noting that the drop continues “the unprecedented long-term decline in cigarette smoking that began with the settlement of lawsuits” brought by state attorneys general against the major tobacco companies.

Paxil Class-Action Suit Hits GSK

Families of adolescents who took paroxetine (Paxil) and attempted suicide have filed suit against GlaxoSmithKline in federal court, claiming that the drugmaker “defrauded the medical profession, the Paxil patient population, and the general public.” The suit alleges, among other things that GlaxoSmithKline “hired doctors to present 'posters' around the world at medical conferences which claimed, falsely, that Paxil was effective and safe for the treatment of depression with children and adolescents.” In one case that spurred the suit, a pediatrician prescribed Paxil for an 11-year-old boy to treat separation anxiety disorder, according to plaintiffs' attorneys. The boy “immediately began having difficulty sleeping and had angry outbursts while on Paxil, but his family did not make the connection between his deteriorating behavior and the drug,” according to the suit. One month later, he hanged himself with the dog's leash in the family laundry room. The boy's mother filed the class-action suit in March in Philadelphia. The complaint notes that although the drug has never been approved for use in pediatric patients, GlaxoSmithKline “has conducted a number of clinical trials involving the use of Paxil with pediatric patients… GSK's own documents admit that the results of these clinical trials did not show a statistically significant benefit over placebo,” the plaintiffs claimed.

Bush Whacked in Health Care Poll

Americans have a low level of trust and confidence in President Bush when it comes to improving the U.S. health care system, a Wall Street Journal Online/Harris Interactive poll found. Only 25% of adults are “confident or very confident” that the president can reduce the percentage of Americans without health insurance, according to the online survey of more than 2,400 adults. About half (49%) of Republicans expressed this level of confidence, compared with 7% of Democrats and 19% of Independents. Respondents expressed somewhat more trust in the Democrats (45%) and potential 2008 Democratic presidential candidate Sen. Hillary Clinton (D-N.Y.) (41%) to improve the health care system than in the Republicans (31%) and President Bush (30%).

Cancer Site Targets Asian Speakers

A searchable online database of cancer material in 12 Asian languages is now available. The Asian American Network for Cancer Awareness, Research, and Training Web tool (

www.aancart.org/apicem